Maternal mortality in a maternal-fetal medicine intensive care unit.
Maternal mortality in a large, tertiary-care, intensive care, referral center was reviewed for a six-year period. The first three years of the review were prior to the institution of a maternal-fetal medicine intensive care unit, located in the labor-and-delivery suite. The subsequent three years encompassed a period during which an intensive care unit staffed by maternal-fetal medicine specialists and obstetric anesthesiologists was established in the labor-and-delivery suite. The maternal mortality rate was 21.7/100,000, or 10 maternal deaths in 45,984 deliveries, prior to establishment of the unit and 22.1/100,000, or 11 maternal deaths in 49,700 deliveries, after establishment of the unit. The major causes of maternal mortality were pregnancy-induced hypertension, hemorrhage and infection. It appears that a multi-disciplinary team composed of maternal-fetal medicine specialists and obstetric anesthesiologists can provide the same level of care for critically ill obstetric patients that traditionally would be provided by medical intensive care specialists.
Kirshon
B
B
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030.
Hinkley
C M
CM
Cotton
D B
DB
Miller
J
J
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007239:Infections / Q000401:mortality; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D006473:Postpartum Hemorrhage / Q000401:mortality; D011225:Pre-Eclampsia / Q000401:mortality; D011247:Pregnancy; D012128:Respiratory Distress Syndrome / Q000401:mortality; D012189:Retrospective Studies; D013781:Texas